Type 2 Diabetes – Causes, Diagnosis & ICD-10 Documentation

TYPE 2 DIABETES Causes, Diagnosis & ICD-10 Documentation

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas stops producing enough insulin. The article gives an overview about the ICD-10 codes for documenting Type 2 diabetes.

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Diabetes is a lifelong, chronic medical condition that causes a person’s blood sugar to become too high. According to the Diabetes Statistics Report (2017 report) released by the Centers for Disease Control and Prevention (CDC ), about 30.3 million people in the US suffer from diabetes (9.4% of the US population) including 23.1 million people who are diagnosed and 7.2 million people who are undiagnosed. It is estimated that 84.1 million adults (33.9% of the adult U.S. population) have pre-diabetes, which puts them at high risk for developing Type 2 Diabetes. Type 2 diabetes is the most common form of diabetes among US adults. Type 2 diabetes occurs when the body doesn’t produce enough insulin (to function properly) or the body’s cells don’t react to insulin, and the blood sugar gradually gets high. Often diagnosed in older people, this condition also affects children as childhood obesity increases. There is no cure for Type 2 diabetes, but people can better manage this condition through regular exercise, eating a healthy diet and maintaining a healthy body weight. However, if diet and exercise aren't enough to manage blood sugar well, people may also need diabetes medications or insulin therapy. With appropriate diagnosis of this condition in its early stages and timely treatment, people in most cases can reverse the complications caused by this chronic disorder. Physicians can benefit from the services of medical billing outsourcing companies for accurate clinical documentation of diabetes.

Causes and Symptoms Typically, this condition develops when the body becomes resistant to insulin, or when the pancreas stops producing enough insulin. The exact causes of this condition are unknown, although genetics and environmental factors such as excess body weight and physical inactivity seem to be some of the contributing factors. Signs and symptoms of this condition develop slowly. Most cases of diabetes will go undiagnosed for years, even after the onset of the disease. Some of the common signs and symptoms include       

Weight loss Fatigue Blurring vision Frequent urination Increased thirst and constant hunger Slow-healing sores or frequent infections Areas of darkened skin

As the disease progresses, these symptoms become more severe and potentially dangerous.

In addition, physical inactivity, family history, age, gestational diabetes and pre-diabetes can increase risk. Increased body weight, fat distribution and polycystic ovarian syndrome may also raise your risk.

How to Diagnose and Document Type 2 Diabetes As there are no visible symptoms associated with Type 2 diabetes, regular and early screening may help people avoid the more serious complications of this disease. The American Diabetes Association recommends routine screening for Type 2 diabetes beginning at the age of 45 years (especially for overweight people). If the results are normal, it is important to repeat the test every three years. In addition, screening is also recommended

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for obese people (under 45 years of age) who have a history of heart disease or diabetes risk factors present such as - sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure (above 140/90 millimeters of mercury (mm Hg). As part of the screening program, physicians recommend different types of tests such as - glycated hemoglobin (A1C) test, random blood sugar test, fasting blood sugar test and oral glucose tolerance test.

Management of Type 2 diabetes requires a systematic effort on the part of patients on reducing the symptoms and potential risk factors that contribute to this condition. The high blood sugar level can be effectively managed by following healthy eating habits, regular exercise, regular blood sugar monitoring and possibly, diabetes medication or insulin therapy. Accurately diagnosing the condition and submitting proper clinical documentation helps in promoting error-free billing practices. Relying on the services of a professional medical coding company can ensure this. ICD-10 codes for diagnosing Type 2 diabetes include – E11 - Type 2 diabetes mellitus E11.0 - Type 2 diabetes mellitus with hyperosmolarity  

E11.00 - Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) E11.01 - Type 2 diabetes mellitus with hyperosmolarity with coma

E11.1 - Type 2 diabetes mellitus with ketoacidosis  

E11.10 - Type 2 diabetes mellitus with ketoacidosis without coma E11.11 - Type 2 diabetes mellitus with ketoacidosis with coma

E11.2 - Type 2 diabetes mellitus with kidney complications   

E11.21- Type 2 diabetes mellitus with diabetic nephropathy E11.22 - Type 2 diabetes mellitus with diabetic chronic kidney disease E11.29 - Type 2 diabetes mellitus with other diabetic kidney complication

Most people tend to ignore Type 2 diabetes, especially in the early stages when the symptoms do not lead to any higher complications. But diabetes affects many organs, including the heart, blood vessels, nerves, eyes and kidneys. Therefore, controlling blood sugar levels can help prevent these complications.

High-Fiber Diet May Help in Better Control of Type2 Diabetes – Finds Study A new study found that consuming a high- fiber diet can help in the fight against Type 2 diabetes, by promoting a group of healthy gut bacteria. A diet high in fiber leads to better glucose control, greater weight loss and better lipid levels in people with Type2 diabetes.

The study was conducted by researchers at the Rutgers University, New Brunswick and the results were published in the Journal Science.

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The six-year study conducted by researchers shows that dietary fibers may rebalance the gut microbiota, the ecosystem of bacteria in the gastrointestinal tract that help digest food.

A high-fiber diet can help promote some 15 strains gut bacteria that produce short-chain fatty acids or SCFA. The SCFA also helps in reducing inflammation in the gut, helps regulate hunger and also provides energy to gut cells.

The study included a 27–person treatment group and participants were given a large amount of dietary fibers, along with a similar diet for energy and major nutrients. A control group of 16 received standard patient education and dietary recommendations. In addition, both groups consumed drug acarbose to help control blood glucose.

Twelve weeks after the study started, it was found that participants who were on a highfiber diet witnessed a higher reduction in blood glucose levels (on a 3 month average) when compared to people who received normal care. In addition, their fasting blood glucose levels decreased faster and they lost more weight than the standard care group. Only 15 out of the 141 identifiable strains of short-chain fatty acid-producing gut bacteria are likely to be the key drivers of better health, researchers say, but they became the dominant strains in the gut after boosting short-chain fatty acids butyrate and acetate. They also led to increased insulin production and better blood glucose control. Researchers have identified 15 SCFA-producing strains that are specifically promoted by fibrous foods. They augment SCFA production which results in better gut health. These bacteria compete with harmful microbes that release compounds that hinder metabolism.

Researchers plan to conduct more studies to check if greater changes to the gut microbiota could do more to help treat Type2 diabetes – possibly even curing the condition.

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